Gauteng health services need improvement
Poor response times by ambulances, lack of staff in hospitals, patients’ rights not respected and no monitoring or evaluation systems in public hospitals are but some of the concerns raised by civil society organisations. At a workshop on the planned National Health Insurance scheme in Johannesburg this week, they said too many a times patients’ lives are put at risk by public health institutions. Karen Peters, an independent researcher specialising in social policy, says a lack of resources is another concern.
“There is a lack of access to nurses, doctors. And health facilities are particularly problematic. I think the way that they are spread out within communities doesn’t always make sense to them. And general access to resources…We heard stories in the workshop about how there were hospitals with new equipment, but none of the staff knew how to use that equipment. It’s also clear that there was lack of access to medication, long queues, long waiting times and staff attitudes was also once again very problematic”.
The workshop is one of nine that the Black Sash, a human rights organisation is conducting around the country. The workshops are aimed at getting ordinary South Africans involved in helping improve the quality of health care by giving inputs and providing solutions. The Gauteng leg of the workshop also highlighted the fact that community health workers have proven to be effective in helping the greater community access health services in their areas. Peters explains.
“Their roles need to be developed in terms of systems and laws to be put in place to ensure that they do not get taken advantage of. There is a clear fundamental role for them in communities and, often, they provide care where the health system fails. So, there is a need to recognise what they do and find ways to integrate them completely and formally into the health system”, says Peters.
The Central Gauteng Mental Health Society was also present. The manager at the Ekhurhuleni branch, Naku Masuku, says her observation is that people with mental illnesses are still not treated like other ordinary patients when they go to public health institutions. Masuku explained further.
“You find that if they go to any normal hospital or psych hospital they are not taken into consideration like other patients. And, even if they are there and need immediate care you will find that because people think they are crazy, they would make them wait. In terms of medication, some of the clinics don’t order enough to cover them and for the patient that is a critical issue because if they are supposed to return for medication and don’t receive it, they relapse. It is absolutely critical for clinics to have sufficient medication in stock to cater for them”.
Masuku says another critical issue is the lack of access to health facilities for people with mental illnesses. It would seem that public health facilities are not equipped to deal with patients with mental illness.
“They will admit them for time being; then, suddenly without communicating with you they release them in the same situation back into the community. That patient becomes a danger to the family and himself. There is supposed to be a 72-hour observation. After that they should then be taken to an institution for further treatment. But they overlook that”.
The workshops have also highlighted some direct similarities across the provinces that hinder people from accessing quality health care. Advocacy Programme Manager at Black Sash, Elroy Paulus explains.
“The lack of appropriate staff attitudes, poor quality of services of health staff, that could be because the staff is highly stressed due to the long queues, but that’s no excuse not to implement the Batho Pele principles. In Kwa-Zulu Natal, we’ve heard that people are grateful for having a 24-hour service at the Prince Mshiyeni Hospital, but at the same time that is unacceptable for nurses to put patients in queues according to illness, talk in a derogatory manner to old people, etc”.
Paulus also highlighted the uneven health services between urban and rural and rich and poor areas, saying these result in people migrating to bigger cities for specialised treatment.
“Many people migrate inter-provincially, like from Mpumalanga to Gauteng, Limpopo to Gauteng to access more specialised care. That points to the need for poor people to find some kind of support by the state for going long distances to get access to health. The lack of access to medication points to poor inter-governmental relations. In the Eastern Cape, Umtata receives supplies. And a place like Mqandule... you find excellent services, but all they can administer to a sick person is Panado”, says Paulus.
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